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TRIAGE

TRIAGE. THE KILLERS. Airway obstruction Excessive bleeding Shock. Unit Objectives. Define Mass Casualty Incident & Disaster Understand & know S.T.A.R.T Knowing the functions of a Disaster Operation Triage Treatment Transport Morgue. Unit Objectives.

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TRIAGE

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  1. TRIAGE

  2. THE KILLERS Airway obstruction Excessive bleeding Shock

  3. Unit Objectives • Define Mass Casualty Incident & Disaster • Understand & know S.T.A.R.T • Knowing the functions of a Disaster Operation • Triage • Treatment • Transport • Morgue

  4. Unit Objectives • Knowing how to TRIAGE a group of Patients • Knowing when to use the techniques for opening airways, controlling bleeding, and treating for shock. • Selecting Treatment Site Area

  5. What is a Mass Casualty Incident ? An Incident that overwhelms the resources of an agency or area. A Multiple Casualty Incident is one that DOES NOT overwhelm resources

  6. Define a Disaster • A disaster is a tragic event that disrupts the normal routine of life, causing loss of property and life and suffering. • Natural (Weather, Earthquake, Flood) • Man Made (Explosion, Shooting, Train Accident) • Disasters occur at many levels—individual, family, neighborhood, community/city, region and national.

  7. Functions of Emergency Medical Operations • Triage • Treatment • Transport • Morgue

  8. S.T.A.R.T Simple Triage And Rapid Treatment

  9. S.T.A.R.T. Triage Method • Style of Triage used by the City of Virginia Beach EMS, Fire, and VBCERT • Method of Triage used across the Commonwealth of Virginia as well as other states • Utilizes a color code for easy recognition of patient condition

  10. Triage • French word meaning…“to sort” • Effective strategy for: • Multiple or mass casualties • Limited resources • Situations where time is critical

  11. Triage involves: • Coverage of as much area as possible in short time • Rapid assessment (30 seconds max) • Rapid treatment of life threats only (No CPR)

  12. S.T.A.R.T Triage Method Immediate (I) “RED” • Immediate treatment and transport required! Delayed (D) “YELLOW” • Treatment and transport needed, but can wait (delayed) Walking Wounded “GREEN” • Minor, non-life threatening injuries (walking wounded) Dead “BLACK”

  13. START Demonstration

  14. FEMA Triage Method Federal Method (FEMA/Office of Domestic Preparedness) • Immediate • Delayed • Dead

  15. VBCERT Triage Combination • The VBCERT uses both: A: FEMA method B: S.T.A.R.T. Method • Gives our team members greater flexibility in working alongside other responders • Depends on location of disaster to which type of triage

  16. Basis for Emergency Medical Operations • Knowing the need for emergency medical operations is based on two assumptions • The number of victims will exceed the local capacity for treatment. • Survivors will assist others.

  17. Triage – Size up • Stop, look, listen… • Evaluate safety for yourself, partner, and bystanders • Conduct voice triage “Everyone who can hear my voice come to me” = walking wounded/tagged GREEN

  18. Triage - Size up • Direct walking wounded to a safe location and have them stay there • Pick a systematic route to search for survivors • Triage evaluation – 30 seconds max • Treat “I”- (RED) victims immediately • ONLY treat life threats!! • All IMMEDIATE triage patients receive; airway control, bleeding control, and treatment for shock. • Document triage results

  19. TRIAGE PROCEDURE • Check Airway/Breathing. At arms distance, shake the victim and shout. • Does the Victim Respond? • Position Airway • Look, Listen, and Feel • If victim is not breathing after 2 attempts to open airway, then tag “Dead” (BLACK) • Check rate Abnormal Respirations > 30 per min. indicates shock. Treat for Shock and Tag “I” (RED)

  20. TRIAGE PROCEDURE • Check Circulation / Bleeding. • Take immediate action to control Bleed • Check circulation using blanch test (Cap refill) • Treat for Shock if normal color takes longer than 2 seconds to return, and Tag “I” (RED)

  21. TRIAGE PROCEDURE • Check Mental Status. • Give Simple Commands, such as “Squeeze my hand.” • Inability to respond indicates that immediate treat for shock is needed. • Treat for Shock and Tag “I” (RED) • If Victim PASSES all Tests His or Her Status is “D” (YELLOW)

  22. Rules for TAGGING • Everyone gets Tagged • If Victim fails one test Tag “I” (RED) • All victims Tagged “I” (RED) get: • Airway Control • Bleeding Control • Treatment for Shock • Victims can move green to yellow, yellow to red, and red to black.

  23. Triage Pitfalls • No team plan, organization, or goal • Indecisive leadership • Too much focus on one injury • Too much time taken with one patient • Treatment (rather than triage) performed

  24. Patient #1 Broken leg, does not respond to voice commands, labored breathing IMMEDIATE Patient #2 Ambulatory, responsive to voice, minor bleeding, normal blanch WALKING WOUNDED Patient #3 Bleeding extremity, unconscious, not breathing DEAD Patient #4 Standing, unresponsive to voice IMMEDIATE Patient #5 No signs of bleeding, conscious, unresponsive to voice IMMEDIATE Triage Exercise Review

  25. Now Lets Practice

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